Please list any food or medical allergies of which we should be aware. Please be sure to list who has this allergy.

*

Please type "NONE" if there are no allergies

Emergency Contact

*

Please list someone who will not be at camp.

Relation

*

Emergency Contact phone number

*

HOUSING: I/We will be using/are requesting

*

*Please note: Cabins & Mill House Room space for families to stay together is limited and is assigned based on need and timing of registration.

If your first choice of housing is unavailable, please list your second choice

I/We will be at Camp Christian for all meals?

*

Yes

No

If no, check which meals you will have at Camp Christian

*

Friday Dinner (6pm)

Saturday Breakfast

Saturday Lunch

Saturday Dinner

Sunday Breakfast

Sunday Lunch

Sunday Dinner

I give my permission to Camp Christian for medical treatment to be administered in such case as deemed necessary by a trained medical professional. I accep and assume all risks associated with recreation activities, and I hereby release Camp Christian of all liability from injuries that might occur. I understand that I am responsible for providing my own insurance for any injuries taht occur while at Camp Chritian. I recognize that this event is for spiritual enrichment and I agree to attend all sessions. I release all photos, videos, and audio recordings to Camp Christian for promotional purposes.

Signature

*

By typing my name above, I certify that I have read and agree to the above statements.

Spouse Signature

By typing my name above, I certify that I have read and agree to the above statements.

Other Adult Signature (If you are registering an adult child who lives at home with you)

By typing my name above, I certify that I have read and agree to the above statements.

Registration Fees - Includes Late Fee included after Aug 22nd

Quantity

$50 - Adults

$30 - Youth ages 12-17

$20 - Youth ages 5-11

$0 - Youth ages 0-4

$30 - Deposit Only

Other Amount

$

Yes, add 3% to my total amount to help cover the payment processing fees